Magazine article Clinical Psychiatry News

THE Media on My Mind: Mental Illness on Big, Small Screens

Magazine article Clinical Psychiatry News

THE Media on My Mind: Mental Illness on Big, Small Screens

Article excerpt

"Silver Linings Playbook," one of nine pictures nominated for the Oscars last year, featured a bipolar hero. (The last nominee with an Axis I protagonist was "A Beautiful Mind," a lamentably inaccurate portrayal of paranoid schizophrenia, which nevertheless became a beautiful gold mine for Universal Studios.)

My research shows that "Play-book" is one of a half handful of films about bipolar disorder. This set me wondering about the prevalence of various psychiatric disorders in a small group of so-called "mental health" movies focused on the specific syndrome of the hero/heroine, as well as many more movies from other genres that provide sufficient material to infer a character's diagnosis.

Why has cinema favored some disorders while others go neglected? Obviously, there are no statistics on this score. The following remarks about what I'll call "cine-diagnostics" are based my own impressions rather than established fact.

Whether a feature film (I'm excluding documentaries) focuses on a specific psychiatric disorder or contains characters so well drawn that a diagnosis can be sussed out, filmmakers have always been especially attracted to syndromes that they perceive as hallmarked by especially melodramatic symptoms and behavior. (Of course, the disorder's presentation might not be as electrifying in real-world psychiatry.)

I suspect that producers and filmmakers conceive that characters with "spectacular" symptomatology offer more entertaining narrative possibilities than less sensational maladies, thereby generating bigger box office revenues. When it comes down to the wire, a disorder's prevalence or clinical accuracy usually will not count as much to the industry as the picture's profit potential.

That's not always a bad thing.

The largest group of "mental health" movies was produced from about 1957 to 1963, a period in which increasing public knowledge about psychiatric illness coincided with greater acceptance of its treatment. Krin and Glen 0. Gabbard have explored this golden age of "pro-therapy" pictures in their estimable "Psychiatry and the Cinema" (Washington: American Psychiatric Association Publishing, 1999).

The Gab-bards note that former World War II military physicians, who became conversant with promising new therapies during service, were instrumental in demystifying psychiatry upon returning to America. (These methods were often taught by emigre psychoanalysts who had fled Nazi persecution.) Not unsurprisingly, some of the most popular pro-therapy movies were about wartime and post-war post-traumatic stress disorder. Films like "Home of the Brave" (1949) often portrayed PTSD 's more melodramatic features.

After the Golden Age, other "spectacular" syndromes depicted in mental health pictures and popular genres included: conversion disorder ("Freud," 1962); multiple personality disorder ("The Three Faces of Eve," 1957); dissociative disorder ("The Swimmer, 1968"); erotomania/de Clerambault's syndrome ("Fatal Attraction," 1987; "The Story of Adele H," 1975); alcoholic hallucinosis and delirium tremens ("The Lost Weekend," 1945); acute schizophrenia ("The Snake Pit," 1948); and compulsive gambling ("The Lady Gambles," 1949; "California Split," 1974).

Antisocial personality disorder was, and still remains, the most prevalent--often immensely popular--Axis II category, particularly in mainstream fare featuring sociopathic characters who relish mayhem and murder ("The Talented Mr. Ripley," 1999). Movies about antisocial serial killers have done so well in recent years that they've become an industry staple ("Silence of the Lambs," 1991; "Manhunter,"1986). …

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